Carpal Tunnel Treatment

Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel — a narrow passageway in the wrist formed by bones and ligaments. This compression causes numbness, tingling, and weakness in the thumb, index, middle, and ring fingers that can significantly impact your ability to work and perform daily tasks.

Common symptoms of carpal tunnel syndrome include:

• Numbness and tingling in the fingers — particularly the thumb, index, and middle fingers, often worse at night or upon waking
• Waking up with numb hands — a classic early symptom caused by wrist position during sleep compressing the nerve
• Dropping objects — reduced grip strength and coordination that makes it difficult to hold small items securely
• Pain radiating up the forearm — aching that extends from the wrist toward the elbow, especially after prolonged hand use
• Weakness in the thumb — difficulty with pinching, buttoning, or tasks requiring fine motor control

The condition is common in people who perform repetitive hand and wrist movements, particularly those involving gripping, typing, or vibrating tools. Other risk factors include pregnancy, diabetes, thyroid conditions, and prior wrist fractures. Mild to moderate carpal tunnel syndrome responds well to conservative treatment, but early intervention is key — the longer the nerve remains compressed, the more difficult full recovery becomes.

Our conservative approach at The Back Clinic aims to reduce pressure on the median nerve, create more space within the carpal tunnel, and address all contributing factors along the nerve pathway from the neck to the hand.

Your individualized plan may include:

• Nerve gliding exercises — specific movements that improve median nerve mobility and reduce adhesions within the carpal tunnel
• Tendon gliding exercises — exercises that promote smooth movement of the finger flexor tendons, reducing crowding and pressure in the tunnel
• Wrist and hand mobilization — manual techniques to optimize carpal bone alignment and wrist mechanics
• Cervical and thoracic treatment — addressing double crush scenarios where the nerve is also restricted at the neck or elbow, which can amplify wrist-level symptoms
• Splinting recommendations — night splints to maintain a neutral wrist position and reduce overnight nerve compression that causes morning numbness
• Ergonomic assessment — workstation modifications and tool adjustments to reduce wrist strain during daily activities and work tasks
• Strengthening — progressive grip and hand exercises to rebuild functional capacity as symptoms improve

Every session is one-on-one with a licensed physical therapist who provides direct, hands-on treatment. This individualized approach allows your therapist to perform skilled manual techniques, monitor nerve response closely, and adjust your program based on how your symptoms are progressing.

Your evaluation includes specific diagnostic tests for carpal tunnel syndrome — including Phalen’s test, Tinel’s sign, and carpal compression testing — along with grip and pinch strength measurement, sensation testing, and screening of the cervical spine and elbow to rule out other sources of hand numbness. This thorough assessment ensures we accurately identify the cause and severity of your symptoms. Wear comfortable clothing that allows access to your arm from neck to hand.

Most patients with mild to moderate carpal tunnel syndrome see significant improvement in symptoms within four to eight weeks of consistent treatment and nighttime splint use. Nighttime numbness and morning tingling are often the first symptoms to improve. Your therapist will track your progress objectively so you can see measurable changes over time.

If symptoms are severe or do not respond to conservative care within a reasonable timeframe, your therapist will discuss whether surgical consultation may be appropriate. Even after carpal tunnel release surgery, physical therapy plays an important role in optimizing recovery and restoring full hand function.

We accept most major insurance plans, including Medicare and Medicare Advantage. In Delaware, you do not need a physician referral to begin physical therapy. Our front desk team can verify your benefits before your first visit. Call (302) 998-7681 or use our online scheduling tool to book your evaluation.